Derek's sister visits from Los Angeles to ask for help on a case; Cristina and Owen have a very unpleasant session of marriage counseling; Alex realizes that he must have better people skills to be a good doctor; and Meredith gets a shot at glory when a patient comes in who had caught his hand in a meat grinder. The residents continue to prepare for their upcoming oral boards.

Archer and Lana must help Mallory after she finds herself in an awkward situation with the Italian Prime Minister.

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